Provider Demographics
NPI:1396005716
Name:ANDREA GARRY, PSYD, PLLC
Entity type:Organization
Organization Name:ANDREA GARRY, PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:913-328-0108
Mailing Address - Street 1:80 E HARTSDALE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2806
Mailing Address - Country:US
Mailing Address - Phone:914-328-0108
Mailing Address - Fax:914-328-0808
Practice Address - Street 1:80 E HARTSDALE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2806
Practice Address - Country:US
Practice Address - Phone:914-328-0108
Practice Address - Fax:914-328-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013724103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty